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2017 ; 4
(ä): 87
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Fluorescence In Situ Hybridization for Diagnosis of Whipple s Disease in
Formalin-Fixed Paraffin-Embedded Tissue
#MMPMID28691008
Braubach P
; Lippmann T
; Raoult D
; Lagier JC
; Anagnostopoulos I
; Zender S
; Länger FP
; Kreipe HH
; Kühnel MP
; Jonigk D
Front Med (Lausanne)
2017[]; 4
(ä): 87
PMID28691008
show ga
Whipple's disease (WD) is a rare chronic systemic infection with a wide range of
clinical symptoms, routinely diagnosed in biopsies from the small intestine and
other tissues by periodic acid-Schiff (PAS) diastase staining and
immunohistological analysis with specific antibodies. The aim of our study was to
improve the pathological diagnosis of WD. Therefore, we analyzed the potential of
fluorescence in situ hybridization (FISH) for diagnosing WD, using a Tropheryma
(T.) whipplei-specific probe. 19 formalin-fixed paraffin-embedded (FFPE) duodenal
biopsy specimens of 12 patients with treated (6/12) and untreated (6/12) WD were
retrospectively examined using PAS diastase staining, immunohistochemistry, and
FISH. 20 biopsy specimens with normal intestinal mucosa, Helicobacter pylori, or
mycobacterial infection, respectively, served as controls. We successfully
detected T. whipplei in tissue biopsies with a sensitivity of 83% in untreated
(5/6) and 40% in treated (4/10) cases of WD. In our study, we show that
FISH-based diagnosis of individual vital T. whipplei in FFPE specimens is
feasible and can be considered as ancillary diagnostic tool for the diagnosis of
WD in FFPE material. We show that FISH not only detect active WD but also be
helpful as an indicator for the efficiency of antibiotic treatment and for
detection of recurrence of disease when the signal of PAS diastase and
immunohistochemistry lags behind the recurrence of disease, especially if the
clinical course of the patient and antimicrobial treatment is considered.